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Peripheral Nervous System & Reflexes

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Peripheral Nervous System & Reflexes Peripheral Nervous System & Reflexes • General anatomy of PNS • Cranial nerves • Somatic reflexes • Autonomic NS: anatomy • Autonomic NS: physiology Subdivisions of the PNS • Sensory (afferent) division carries sensory signals from receptors to CNS – somatic sensory -- skin, muscles, bones & joints – visceral sensory -- viscera • Motor (efferent) division carries motor signals from CNS to effectors (glands and muscles) – somatic motor supplies skeletal muscles – visceral motor supplies cardiac, smooth & glands • sympathetic division -- tends to arouse • parasympathetic division -- tends to calm • Mixed nerves carry sensory & motor signals Anatomy of Nerves • A nerve is a bundle of nerve fibers (axons) • Epineurium covers nerves, perineurium surrounds a fascicle and endoneurium separates individual nerve fibers creating room for capillaries Anatomy of Ganglia in the PNS • Cluster of neuron cell bodies in nerve in PNS • Dorsal root ganglion is sensory cell bodies – fibers pass through without synapsing • Autonomic ganglion does contain synapse of preganglionic fiber onto postganglionic cell body The Cranial Nerves • 12 pair of nerves that arise from brain & exit through foramina leading to muscles, glands & sense organs in head & neck • Input & output remains ipsilateral except CN II & IV Olfactory Nerve • Provides sense of smell • Damage causes impaired sense of smell Optic Nerve • Provides vision • Damage causes blindness in visual field Oculomotor Nerve • Provides some eye movement, opening of eyelid, constriction of pupil, focusing • Damage causes drooping eyelid, dilated pupil, double vision, difficulty focusing & inability to move eye in certain directions Trochlear Nerve • Provides eye movement • Damage causes double vision & inability to rotate eye inferolaterally Trigeminal Nerve • Main sensory nerve to face (touch, pain and temperature) and muscles of mastication • Damage produces loss of sensation & impaired chewing Abducens Nerve • Provides eye movement • Damage results in inability to rotate eye laterally & at rest eye rotates medially Facial Nerve • Provides facial expressions, sense of taste on anterior 2/3’s of tongue, salivary glands and tear, nasal & palatine glands • Damage produces sagging facial muscles & disturbed sense of taste (missing sweet & salty) Branches of Facial Nerve Vestibulocochlear Nerve • Provides hearing & sense of balance • Damage produces deafness, dizziness, nausea, loss of balance & nystagmus Glossopharyngeal Nerve • Provides control over swallowing, salivation, gagging, sensations from posterior 1/3 of tongue, control of BP and respiration • Damage results in loss of bitter & sour taste & impaired swallowing Vagus Nerve • Provides swallowing, speech, regulation of most of major viscera • Damage causes hoarseness or loss of voice, impaired swallowing & fatal if both are cut Accessory Nerve • Provides swallowing, head, neck & shoulder movement • Damage causes impaired head, neck & shoulder movement, head turns towards injured side Hypoglossal Nerve • Provides tongue movements of speech, food manipulation & swallowing • Damage results in inability to protrude tongue if both are damaged or deviation towards injured side & ipsilateral atrophy if one side is damaged The Spinal Nerves • 31 pairs of spinal nerves (1st cervical above C1) – mixed nerves exiting at intervertebral foramen • Proximal branches – dorsal root is sensory input to spinal cord – ventral root is motor output of spinal cord – cauda equina is roots from L2 to C0 of the cord • Distal branches – dorsal ramus supplies dorsal body muscle & skin – ventral ramus to ventral skin & muscles & limbs – meningeal branch to meninges, vertebrae & ligaments Nerve Plexuses • Ventral rami branch & anastomose repeatedly to form 5 nerve plexuses – cervical in the neck, C1 to C5 • supplies neck and phrenic nerve to the diaphragm – brachial in the armpit, C5 to T1 • supplies upper limb and some of shoulder & neck – lumbar in the low back, L1 to L4 • supplies abdominal wall, anterior thigh & genitalia – sacral in the pelvis, L4, L5 & S1 to S4 • supplies remainder of butt & lower limb – coccygeal, S4, S5 and C0 Structure of a Nerve Plexus • Notice the branching and merging of nerves in this example of a plexus Cutaneous Innervation & Dermatomes • Each spinal nerve receive sensory input from a specific area of skin called dermatome • Overlap at edges by 50% – a total loss of sensation requires anesthesia of 3 successive spinal nerves Nature of Somatic Reflexes • Quick, involuntary, stereotyped reactions of glands or muscle – automatic responses to sensory input that occur without our intent or often even our awareness • Functions by means of a somatic reflex arc – stimulation of receptors – afferent fibers carry signal to spinal cord – interneurons integrate the information – efferent fibers carry impulses to effectors – skeletal muscles respond The Muscle Spindle • Sense organs that monitor the length of skeletal muscles (proprioceptors) • 4 to 10 mm long modified skeletal muscle cells – intrafusal fibers that respond to gamma motor neurons & are wrapped with afferent fibers that respond to stretch The Stretch Reflex • When a muscle is stretched, it contracts & maintains increased tonus (stretch reflex) – helps maintain equilibrium & posture • head starts to tip forward as you fall asleep – stabilize joints by balancing tension in extensors & flexors – smooth muscle actions • Very sudden muscle stretch causes tendon reflex – knee-jerk (patellar) reflex is monosynaptic reflex • Reciprocal inhibition prevents muscles from working against each other The Patellar Tendon Reflex Arc Withdrawal & Crossed Extensor Reflexes • Flexor(withdrawal) reflex is withdrawal of foot • Crossed extensor reflex is maintaining balance by extending other leg Golgi Tendon Reflex • Proprioceptors in a tendon near its junction with a muscle -- 1mm long, encapsulated nerve bundle • Excessive tension on tendon inhibits motor neuron – muscle contraction decreased • Also functions when muscle contracts unevenly Somatic versus Autonomic Pathways Autonomic NS: Visceral Reflexes • Target organs are glands, cardiac & smooth muscle • Receptors detect internal stimuli -- stretch, etc – baroreceptors detect BP, CN IX send signals to medulla, CN X sends signals to heart to reduce BP • ANS is the efferent neurons of these reflex arcs – 2 neurons span the distance from CNS to effectors • presynaptic neuron cell body in CNS -- brain or spinal cord • postsynaptic neuron cell body in peripheral ganglion – ANS modifies effector activity rather than causing it • smooth & cardiac muscle show denervation hypertrophy Autonomic Reflex Arc Anatomy of Sympathetic NS • Origin of presynaptic neurons – lateral horns of gray matter of thoracic to lumbar cord – fibers exit via spinal nerves T1-L2 • Sympathetic chain ganglia (paravertebral) – white and gray communicating rami suspend ganglia from spinal nerve – pathways of preganglionic fibers • enter ganglia & synapse • travel to higher or lower ganglia & synapse • pass through chain without synapsing to reach collateral ganglia via splanchnic nerves CONTINUE Efferent Pathways of Sympathetic NS Pathways of Preganglionic Sympathetic Fibers Collateral Ganglia & Abdominal Aortic Plexus Adrenal Glands • Paired glands sit on superior pole of each kidney • Cortex – secretes steroid hormone • Medulla – modified sympathetic ganglion that secretes neurotransmitters (hormones) into blood and not onto other neurons • 85% epinephrine & 15% norepinephrine – complementary involvement in mass activation that occurs during fight or flight reaction Anatomy of the Parasympathetic NS • Origin of preganglionic fibers – pons and medulla oblongata (cranial nerve nuclei) – spinal cord segments S2-S4 • Pathways of preganglionic fibers – cranial nerves III, VII, IX and X • cardiac, pulmonary, esophageal, abdominal aortic plexus – arising from sacral spinal cord • pelvic splanchnic nerves & inferior hypogastric plexus • Terminal ganglia in target organs due to normally short postganglionic fibers Efferent Pathways of Parasympathetic NS Neurotransmitters & Receptors • Cholinergic fibers secrete ACh while adrenergic fibers secrete NE – only postganglionic sympathetic fibers are adrenergic Cholinergic Receptors • Acetylcholine binds to 2 classes of receptors – nicotinic receptors • occur on all ANS postganglionic neurons, adrenal medulla, on skeletal muscle • excitatory when ACh binding occurs – muscarinic receptors • occur on all gland, smooth muscle & cardiac muscle that receives cholinergic innervation • either excitatory or inhibitory when ACh binding occurs Adrenergic Receptors • 2 categories of NE receptors – alpha adrenergic receptors • NE binding is excitatory – beta adrenergic receptors • NE binding is inhibitory • Exceptions to normal results (EPSP or IPSP) – existence of subclasses of each receptor type • alpha 1 and 2; beta 1 and 2 • Function by means of 2nd messengers – beta receptors activate cyclic AMP, alphas2 receptors suppress it and alpha1 receptors use calcium Dual Innervation • Most of viscera receive nerve fibers from both parasympathetic & sympathetic divisions – antagonistic effects oppose each other • exerted through dual innervation of same effector cells – heart slowed down or speeded up • exerted because each division innervates different cells – pupillary dilator muscle & constrictor pupillae change pupil size – cooperative effects seen when 2 divisions act on different effectors to produce a unified effect(salivation) • parasympathetic NS increases
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